Elbow Dislocation

Definition

The elbow includes 3 bones, the humerus of the upper arm, and the radius and ulna of the lower arm. The bottom portion of the upper arm bone sits in a groove in the ulna. The end of the radius lies against the end of the upper arm bone and allows the forearm to rotate. A series of ligaments connects the bones and keeps them in place during movement.

An elbow dislocation occurs when the bones are pulled out of place. It often involves damage to the ligaments and sometimes damage to the bones. A dislocation will make certain movements impossible.

The Elbow Joint

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Causes

Elbow dislocation is caused by a sudden traumatic force on the elbow, such as a fall on an outstretched arm.

Risk Factors

Factors that may increase your chance of elbow dislocation:

• Instability in the structure of your elbow joint
• Previous injury or surgery to your elbow joint
• Playing sports

Symptoms

Elbow dislocation may cause:

• Severe pain at the elbow with or without swelling
• Pain with movement
• Difficulty bending arm or moving forearm
• Bruising
• Abnormal appearance of the elbow

Diagnosis

Your doctor will ask about your symptoms, medical history, and what you were doing when your elbow was injured. Your elbow will be thoroughly examined to check for swelling and tenderness. Your doctor will may be able to make the diagnosis based on your symptoms.

An x-ray may be taken to look for evidence of the dislocation or fractures.

Other imaging tests may be done to see if there is any damage to nerves, blood vessels or ligaments:

• CT scan
• MRI scan

Elbow dislocations are graded according to their severity:

• Simple dislocation—No major bone injury.
• Complex dislocation—Fractures of the bone and damage to surrounding tissue such as ligaments, nerves, and blood vessels are likely.

Treatment

The doctor can manipulate most elbows back into place. Medications to relieve pain and help you relax will be given before the elbow is moved. Once the elbow is repaired, medication will be given to help reduce swelling and pain.

Other aspects of your treatment depend on the severity of the dislocation and other tissue damage.

Immobilization

The elbow joint will be immobilized with a splint or sling to help it heal properly. You may need to wear the support for up to 3 weeks, even if it was a simple dislocation.

Physical Therapy

Exercises and rehabilitation are an important part of recovery. Motion exercises are started as soon as possible to help prevent stiffness and permanent loss of motion.

Physical therapy can help restore strength, range of motion, and flexibility.

Surgery

Complex dislocations may require surgery to:

• Restore proper alignment
• Repair damaged bones ligaments, blood vessels, or nerves

An external hinge may be needed to support the bones while they heal. Future surgeries may also be needed to improve motion and remove scar tissue.

Prevention

To help reduce your chance an elbow dislocation:

• Don’t put your arm out when you fall. If you can, turn your body, fall on your side, and roll.
• Wear protective equipment and use proper technique when playing sports.
• Keep your arm muscles strong with regular exercise.